The holidays are a time for reconnecting with family and eating traditional comfort foods around the table. But it’s a time that can also lead to regrets about what and how much you consume.
The Lakeshore spoke with Gail Hall, DCSW, CEDS-S, executive director of eating disorder services at Sanford Behavioral Health in Marne, about her insights on how to deal with triggers, unhealthy eating behaviors, and how to spot signs of an eating disorder.
The Lakeshore: Tell us a little about your background and your work at Sanford Behavioral Health. When did the facility open, and who does it serve?
I have been a therapist treating eating disorders for 30 years. I owned a practice of therapists and dietitians treating eating disorders where we offered outpatient and intensive inpatient services. Eighteen months ago, the assets of my practice were purchased by Sanford Behavioral Health,
which is well-known in the community for its residential substance use programs. We joined forces to create a full continuum of care for individuals with eating disorders at our beautiful facility in Marne. In addition to intensive outpatient services, we have a partial hospitalization program (PHP), and the very first residential facility for individuals with eating disorders in the state of Michigan. Sanford Comprehensive Treatment for Eating Disorders
currently accepts women over the age of 18 in residential treatment. As we expand services, we anticipate being able to serve male adults, those with co-existing substance use and eating disorders, and individuals with mood disorders and trauma. Our outpatient services support adolescents, adults, and all genders.
TL: Can you explain the psychology of food and holiday traditions?
We come into the world with an instinct and a necessity to eat. Babies fuss and cry when hungry, but they are calm and content when full. A good meal releases the feel-good hormone dopamine. From our earliest days, we begin to associate the feeling of satiety with pleasure. That’s why we refer to foods that are especially satisfying as “comfort” foods. Special holiday meals can be cultural or religious celebrations and often involve extended family or friends. Those associations and memories add to the intensity of the experience.
Having regrets about eating is a learned behavior and is rooted in a society moralizing food as “good” or “bad.” Body size and weight are treated solely as a matter of self-control, so there is shame associated with being perceived — or perceiving oneself — as overindulging. Holiday meals are meant to be feasts, so let’s not look back at our eating patterns with guilt.
TL: What’s the best way to prepare for a family gathering with a lot of expectations about filling our plates with traditional items that may result in regrets later?
GH: Eating behavior is not the problem, it is the psychological regrets that are the problem. Consuming food is supposed to be pleasurable, so go ahead, fill your plate and enjoy it.
At the same time, it is also perfectly acceptable to pass on items because you don’t like them (including your aunt’s famous creamed spinach), say no to additional helpings that Grandma wants you to consume, or save room for dessert.
You are the only one who can decide when you are full.
If you have a family member in recovery from an eating disorder, a large family gathering for a holiday meal may be very difficult. Speak with your loved one to see how you could best support them, him or her. An advance plan for the meal and the conversation can be extremely important.
TL: What coping methods do you recommend when people feel like they are falling back into old habits at holiday events?
Many are likely to approach holiday meals overly hungry due to skipping meals earlier in the day. This is destined to fail because feeling famished makes it difficult to recognize your body’s cues and respond correctly to its needs.
A better strategy is to have a plan:
TL: What are some healthy habits around food that we can begin practicing now to gear up for the holidays?
- Choose the foods you really enjoy.
- Don’t take a little of everything just to be polite.
- Eat slowly and take time for good conversation.
- Avoid or limit alcohol, which also interferes with hunger and fullness cues.
It’s faulty thinking to suggest that we need to compensate in advance for the holiday season. A healthy habit is to have a lifelong, day-in and day-out approach to food, which should include “all things in moderation.”
While it sounds so simple, it’s not easy to practice, which is why it requires more than just a
TL: What are the signs that someone might need to seek help for an eating disorder?
There are several types of eating disorders. Anorexia involves refusing food, avoiding meals, and being overly preoccupied with weight and body size. The individual may lose weight and have a visibly changed physical appearance. However, eating disorders are emotional problems rooted in distorted thinking and obsessional habits, so weight loss might not be noticeable. Individuals of average size and those with larger bodies can also struggle with anorexia. Some individuals purge food after eating by vomiting, excessive exercise, or the consumption of laxatives or diuretics. This is known as bulimia. There may be laxative wrappers in the trash or signs of vomiting in the bathroom or bedroom. Other individuals will eat little, or consume “normal” meals in public, but binge-eat in secret. These individuals struggle with binge eating disorder. In that case, food may disappear without explanation.
Eating disorders are serious mental health issues, so in addition to changes around food, weight, and shape, be alert for increasing signs of depression and anxiety: withdrawal, isolation, lethargy, and lack of interest in life. Eating disorders also can have very serious, potentially life-threatening consequences, so if your loved one is weak, cold, they pass out, or struggle with low heart rate and low blood pressure, they need immediate medical attention, preferably with a physician who understands eating disorders.